Pocket Reduction/Elimination

Why do I need pocket reduction surgery?
Your Periodontist may have recommended you undergo pocket reduction surgery or osseous surgery. This recommendation is based on your periodontal probing depths. The critical probing depth to keep in mind is 5mm. When periodontal pockets get above 5mm we as dental professionals, with specialty instruments in our hands, are unable to get all of the bacteria deep down in the pockets. If we are unable to get these deep pockets clean there is no way a patient will be able to keep these pockets clean. The end goal of treatment is to give you a mouth that you can keep clean at home and one you can easily maintain on your own.

What is pocket reduction?
Imagine if a person were standing at the base of a cliff and shot a gun. The bullet would not make a 90º turn when it reached the edge of the cliff, but rather it would arc over the top. The same is true of the bone in your mouth. If your bone has sharp irregular areas, the gums cannot follow those contours and will simply arc over the top. With pocket reduction surgery, we remove some of the excess tissue and reshape the bone to restore more natural contours like it did in health. This will allow for the gums to lay down more intimately with the bone and form a tight biologic seal around the teeth. In this way we can turn 6, 7, and 8mm pockets back into 3-4mm which are something that you can keep clean at home.

What are the drawbacks of pocket reduction?
When we reduce the pockets, the tissue will rest lower on the tooth. This can expose some root structure leading to hot/cold sensitivity. Also, the areas between the teeth (embrasures) will now be more open. This will create areas of plaque and food traps. But…it will also give you greater access to get your cleaning aids (proxy brush, rubber tip stimulator) into these areas. Patients who keep these areas clean will have a highly successful outcome. Patients who do not keep these areas clean will break down faster than if we had never worked on them. This is why your home care is so critical.

What causes deep pocket depths?
These deep pockets are a factor of either advanced periodontal disease (in which case scaling and root planning will never solve your problem), or they are a factor of anatomic considerations.

If your deep pockets are a factor of advanced periodontal disease, the problem is access to the bottom of the pocket. With pocket reduction we have 100% visual access all the way to the bottom of the defect to thoroughly clean the teeth. It is this open access which permits us to clean the teeth in a way that could never be done in a closed environment.

If your deep pockets are a factor of anatomic defects then scaling and root planning will never solve the problem. If there are sharp, vertical defects or craters in the bone, the only way to address these are to reshape the bone back to how it looked in a state of health.

PATIENT REVIEWS

Paul G.(Periodontal patient)Jun 29, 2014

Excellent! Top notch! I have been seeing Cindy for over 20 years and love her care and concern for my health. Thanks to Dr. Engen & Cindy the hygienist I still have my teeth!

Denise FJun 29, 2014

I would highly recommend Dr. Engen and his office staff to anyone whose child was apprehensive about having braces. Other than the high level of professionalism, I appreciate the down-play of cutsie-pie gimmicks for kids. He thoroughly explained everything to us right from the start.

Contact Us to Schedule an Appointment!

First Name *

Last Name *

E-mail

Phone * (Example - 4278796743)

Comments *

Preferred Contact?E-mailPhone

Dr. Engen’s New Office is Almost Here

Want to watch an entire day’s worth of construction work being completed in around thirty-seconds? Well now you can. Using a GoPro camera, we filmed the pouring of cement into the common area floor in the basement of the North Nevada Professional Building. Dr. Engen’s new office is coming soon, and we can’t wait!

Dr. David W. Engen, DDS, MSD

Dr. David W. Engen, DDS, MSD 1 of only 5 board certified periodontists in the inland northwest, received his Bachelor of Science degree in Neurobiology from Purdue University and his Master of Science degree in Physiology and Biophysics from Indiana University prior to earning his Doctor of Dental Surgery degree at Indiana University School of Dentistry. He received specialty training in both Periodontics and Orthodontics, making him one of a handful of specialists in the country to hold both specialties. He received the Master of Science in Dentistry degree along with his specialty credentials. Dr. Engen is one of only three board certified Periodontists in the Inland Northwest. Dr. Engen recently became board certified in Orthodontics making him one of less than 20 dentists world-wide to have achieved such a distinction.

Hard At Work On Our New Home!

Dr. Rudolf G. Hahn, DMD, MS

Dr. Rudolf G. Hahn, DMD, MS, 1 of only 5 board certified periodontists in the inland northwest, hails originally from London, England. Dr. Rudolf “Rolf” Hahn started his dental career at Guys Hospital, London in 1972. After graduating he worked in a general dental practice in England and later in Germany. He also received his doctorate in prosthodontics at the University of Cologne, Germany, where he then also served as assistant professor of prosthodontics from 1980 to 1982. Dr. Hahn came to the US to complete his specialty training in Periodontics at Loma Linda University, in California. He stayed on as a faculty member in the school of dentistry in addition to his private practice. During the last five years of his stay at Loma Linda University he served as Chairman of the Department of Periodontics.

HAPPY HALLOWEEN 2014!!!

PATIENT REVIEWS

Larry A.Jun 29, 2014

Because of the internet information provided about his background and education, I feel I have a top level, up-to-date professional taking care of me.

Lyle B. (Periodontal patient)Jun 29, 2014

State of the art care! I like the “get it right” attitude. After eight years I have not had one negative experience.